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Following is a question by Dr Hon Priscilla Leung Mei-fun and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (May 16):
Question:
The Government will launch a four-year pilot scheme on community care service voucher for the elderly (the scheme) next year to provide direct subsidy for eligible elderly people to choose to receive home care and day care services which suit their needs. In the first phase, participants may choose any service up to a value of $5,000 per month and the authorities will provide them with a monthly subsidy of $2,500 to $4,500. In this connection, will the Government inform this Council:
(a) of the progress of the preparatory work for the scheme; given that services in the first phase will focus on elderly people who have been assessed by the Standardised Care Need Assessment Mechanism for Elderly Services of the Social Welfare Department as having impairment at moderate level, of the criteria based on which the authorities assess an individual as "having impairment at moderate level"; of the estimated number of eligible elderly people for the first phase;
(b) of the numbers of non-governmental organisations and non-profit-making organisations (including social enterprises) which to date have been invited and agreed to participate in the first phase of the scheme; of the criteria based on which the authorities determine whether or not individual organisations are suitable to participate in the scheme;
(c) given that the authorities have indicated its intention to introduce a case manager approach to the scheme and proposed that in the first phase, case management be undertaken by service providers and a quality monitoring mechanism be established by the authorities to safeguard service standard, of the progress in establishing the monitoring mechanism; of the specific mode of operation; how they ensure that no conflict of interests will arise when service providers are responsible for both case management and care planning; and
(d) as I have learnt that due to inadequate supply of residential care places for the elderly, quite a number of members of grassroots families need to take care of mobility-handicapped or chronically ill elderly people at home, and they are not able to take up full-time jobs, thus worsening the financial situation of their families, whether the authorities will consider providing additional subsidies on the existing basis to low-income families or individuals who need to take care of elderly people so as to alleviate the financial burden on such carers, with a view to encouraging ageing at home and thus relieving the community's demand for residential care places for the elderly; if they will not, of the reasons for that?
Reply:
President,
The Government will implement a pilot scheme on community care service (CCS) voucher for the elderly (pilot scheme) in 2013-14. The pilot scheme will adopt a "money-follows-the-user" approach, and will provide subsidy directly to eligible elders, enabling them to choose the service provider(s), service types and packages which best suit their needs. We hope to test the viability of voucher which is a new funding mode, and attract different types of service providers to enter the market, thereby promoting further development of CCS. We briefed the Panel on Welfare Services (the WS Panel) of the Legislative Council on the preliminary proposal of the pilot scheme on February 13, 2012, and listened to the views of 30 elderly care associations/concern groups on the pilot scheme at the WS Panel's special meeting on April 27, 2012.
My reply to Dr Hon Priscilla Leung Mei-fun's four questions is as follows:
(a) To allow elders who are most in need to have priority in using subsidised services, we would only invite elders assessed by the Social Welfare Department (SWD)'s Standardised Care Need Assessment Mechanism for Elderly Service (SCNAMES) to have impairment at moderate level or above to participate in the pilot scheme. To facilitate a smooth launch of the scheme, we will first serve elders with moderate level of impairment during the first phase as their care needs are relatively similar.
Under SCNAMES, assessors will adopt an internationally recognised assessment tool named "Minimum Data Set-Home Care" to assess the long-term care needs of elders. The assessment is based on the elder's conditions in various aspects (eg his ability to cope with daily activities, body functioning, memory, communication skills, behaviour and emotion, health conditions, home safety, adequacy of carer support, etc). SCNAMES has been in use since 2000 and is a proven tool.
The pilot scheme aims at testing the viability of voucher which is a new funding mode, rather than meeting the existing service demand. We will therefore launch it in a few selected districts to ensure a smooth operation. The number of places to be offered by the pilot scheme will largely depend on the number of eligible elders, the readiness of service providers in the selected districts, etc. We are mapping out the details of the pilot scheme, and expect that the districts and number of places to be offered can be confirmed this year.
(b) For the first phase of the pilot scheme, we will invite non-governmental organisations and non-profit organisations (including social enterprises) to be service providers, as they are more experienced in the provision of CCS for the elderly. SWD will invite these organisations to submit Expression of Interest within this year.
In selecting service providers, SWD will consider the applicants' relevant experience, service proposals, etc, to make sure that those selected have the capability to deliver the service.
(c) In the first phase of the pilot scheme, the voucher value will be at a flat rate of $5,000 per month. As such, case managers have less budgeting functions to perform, and there will be less conflict of interests in care planning and service provision. Under such circumstance, we believe that service providers can also assume case management responsibilities.
Specifically, service providers acting as case management bodies have to prepare care plans for individual elders and review the plans regularly. SWD will specify the service content with reference to the existing Enhanced Home and Community Care Services and day care services. It will also draw up a set of quality monitoring measures to ensure service quality. SWD will firm up the details this year.
(d) The Government has been providing various types of support services to family carers to alleviate their pressure.
At present, the 41 District Elderly Community Centres (DECCs), 118 Neighbourhood Elderly Centres, 85 Home Care Service Teams and 63 Day Care Centres/Units for the elderly (DEs/DCUs) throughout the territory are providing support services for elderly carers to enhance their caring capabilities. These support services include provision of information, training and counselling, assistance in forming mutual-assistance groups, setting up resource centres, arranging demonstration and loan of rehabilitation equipment, etc. At the same time, residential care homes for the elderly (RCHEs) that provide subsidised places (including private RCHEs participating in the Enhanced Bought Place Scheme) and subvented DEs/DCUs also provide relief to carers through their respective provision of residential/day respite services for the elderly.
In addition, the Government has implemented the District-based Scheme on Carer Training since October 2007. We subsidise DECCs to partner with community organisations in their districts to organise carer training programmes. By December 2011, 119 elderly centres had participated in the scheme and 8 450 individuals had completed the training.
Cherishing the family is one of the core values of the Hong Kong society. The Government has therefore been promoting mutual family support, and we value family carers' contribution to their family members. While the Government cannot replace family functions, we have been providing training courses for family carers to equip them with relevant knowledge and skills. We also offer various types of support services to alleviate their burden. All these measures can help family members of elders discharge their family responsibilities.
Frail elders generally require professional support (such as nursing care, rehabilitation training, etc). We believe that, compared with direct provision of cash subsidy, providing services for them and supporting their carers can better address their needs.
Ends/Wednesday, May 16, 2012
Issued at HKT 12:50
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